Travelling Canadians:
Phone toll-free from within North America: 1-888-881-8013
Phone collect from outside North America: +1-519-945-9246

Visitors to Canada:
Phone toll-free from within North America: 1-877-878-0142
Phone collect from outside North America: +1-(519) 251-5166

Students:
Phone toll-free from within North America: 1-877-331-3134
Phone collect from outside North America: +1-(519) 251-7401

How long do I have to submit a health and dental claim?

To be eligible for reimbursement, individual claims must be submitted within 12 months of the date on which service charges were incurred. For example, a claim for services billed on February 25, 2009, must be submitted by February 25, 2010.

Note: A claim should only be submitted once the total of service bills exceeds the deductible amount, if applicable. When claiming small fee amounts, please accumulate receipts and submit once claims total a reasonable sum.

How quickly will my health or dental claim be processed?

As long as your claim form is complete and accurate, it will be processed within five business days of receipt. Cheques are typically issued within one day of processing.

If information is missing, however, we may have to return the claim form to you, which will delay processing and payment.

How do I submit a health or dental claim?

Provider-Submitted ClaimsFor many health care services covered by your Plan, you may not need to fill out a claim form. Health Care providers such as Provincial or Territorial hospitals and pharmacies and many dentists and optometrists bill Manulife directly for services covered by your plan. This means that you do not need to submit a claim form. When your pharmacist, dentist or hospital bills Manulife directly, but the full amount of the claim is not covered by your policy, such as where you are required to make a co-payment under the Schedule of Benefits section of your Policy or where you have reached your benefit maximum at the time the service is rendered, you will have to pay the balance directly to the provider. It is therefore important that you make the provider aware of any restrictions/exclusions which may apply to your policy.

Insured-Submitted ClaimsIf for any reason your pharmacist, dentist, hospital or optometrist does not bill Manulife directly, you are required to pay the provider and then submit your claim to Manulife for reimbursement of the eligible expense. In addition, if your policy contains a counter offer with a policy exclusion, you may be required to submit your health claims directly to Manulife. Claim forms can be obtained by calling 1-800-COVER ME® (1-800-268-3763), or by visiting our website at http://www.coverme.com/knowledge-centre/forms-library.jsp.

To submit your claim, complete a claim form attaching original receipts (not photocopies or faxes) and all pertinent documentation required for your claim (See "Submitting Claims Directly to Manulife") and send to:

Once your claim has been reviewed and deemed an eligible benefit, a reimbursement cheque will be mailed to you for the eligible portion of the benefit. Please retain the top portion of the cheque for income tax purposes.

Submitting Claims Directly to ManulifeReceiptsPrescription DrugsOriginal receipts (not statements) must show the name of the drug, drug identification number (DIN), date of service, prescription number, strength, quantity, drug cost and dispensing fee.

All Other ReceiptsReceipts (other than prescription drug receipts) must be on the printed letterhead of the person or company providing the service and must clearly show:

name of patient

date(s) of service

description of service

cost of each service rendered.

Prosthetic Appliances/Durable Medical Equipment/Hearing AidsMost provincial health plans contribute toward the cost of prosthetic appliances, durable medical equipment and hearing aids. It is recommended that a written estimate be obtained outlining the charges for the purchase or rental of medical equipment. Manulife will review the estimate and advise you of the amount of benefits payable.

Claims for prosthetic appliances, durable medical equipment or hearing aids must be accompanied by the original receipt, a copy of the provincial health plan contribution statement (including portion paid) along with a written prescription/functional assessment from a certified plan authorizer.

Extended Health Care Services
Charges for the services of a registered:

Chiropractor

Chiropodist

Osteopath

Naturopath

Podiatrist

Registered Massage Therapist*

Acupuncturist

Psychologist*

Physiotherapist*

Speech Pathologist*/Therapist*

* These services require written authorization from your attending physician. Services payable under your policy, including the above mentioned Extended Health Care services, are only payable after any applicable Government Health Insurance Plan (GHIP) yearly dollar benefit maximum has been reached (refer to your Schedule of Benefits). Please refer to the section Claiming Benefits, when making a claim for these services. You must include documentation from your medical practitioner stating the date the GHIP yearly dollar maximum allowance was reached.

Note: Any billing amount within the eligible per visit GHIP allowance is not covered and is your responsibility. Please refer to your Schedule of Benefits for specific coverage.

Homecare and NursingPlease call 1-800-COVER ME® (1-800-268-3763) and follow the prompts to reach the Individual Inquiry Department for information and nursing approval forms prior to commencing such services.

Dental BenefitsDentists are encouraged to submit claims directly to Manulife for reimbursement. This method is fast, economical and convenient for you, as you only need to show your identification card to confirm coverage for the services provided. If a dentist does not submit your claim directly to Manulife, he/she will identify the services provided using the standard dental claim form approved by the Canadian Dental Association. This claim form must then be submitted to Manulife.

Pre-Determination of Dental BenefitsWhen you, your Co-Insured or dependant is about to commence major dental work, we recommend that the dentist provide Manulife with an outline of the proposed treatment plan, including the intended procedures and cost. (X-rays are often required to assess the treatment.)

Vision BenefitTo submit a claim for the purchase of prescription lenses/frames/contact lenses, use the standard Extended Health Care claim form and send it to Manulife, together with the original receipt from the provider.

Accidental Death and Dismemberment BenefitFor details and additional information about the appropriate documentation required, please contact:

Emergency Health Travel CoverageTo make a claim under your Emergency Health Travel Coverage within Canada and the U.S., call 1-800-805-1008. In the event of an emergency while outside of Canada or the U.S., refer to your Manulife world assistance card for the telephone numbers of the appropriate Emergency Assistance Centres.

Important Notes Regarding the Submission of Your Claims

Request for additional information from your health care practitionerFor the purpose of assessing your claims, you may be asked to provide Manulife with additional medical information. In this event, our claims staff will advise you of the specific information that is required in order to complete the assessment of your claim. You will be responsible for any costs associated with obtaining this information. Manulife will generally accept an explanatory note that is written on a medical script pad from the medical practitioner, but on occasion, more detailed information may be required.

Medically NecessaryIn order to be considered for payment, eligible health claims must be deemed medically necessary under the terms of your policy. Preventative dental claims are allowable to the extent they are defined under your policy.

Counter Offer ExclusionsIf your policy was issued with any exclusion, as described in a counter offer agreement made with you, claims are not eligible if they relate to these exclusions. This means that any treatments (including but not limited to medications) relating to the policy exclusion will be exempt from payment. In the event that a treatment, medication or health service, that would otherwise be used to treat an excluded condition is being used to treat an unrelated medical condition, you will be required to provide us with supporting information to this effect from your treating medical practitioner, at the time you submit your claim, in order for it to be considered for payment.

Claims ReviewManulife is committed to providing cost-effective insurance coverage to its Insureds. To this end, our Claims Review Process is designed to verify that claim payments are being made in compliance with the terms of the policy. As such, claims submitted within the first two years that a policy or newly added coverage is in effect, other than dental claims, may be selected for a claims review from time to time.

Deadline for Submission of ClaimsFull written claims satisfactory to Manulife must be submitted within 12 months from the date charges are incurred. Faxes and photocopies of documentation are not acceptable.

When/How will I know if my claim has been approved?

As long as your claim form is complete and accurate, it will be processed within five business days of receipt. Cheques are typically issued within one day of processing.

If information is missing, however, we may have to return the claim form to you, which will delay processing and payment.

To keep up-to-date on the status of your claim form, you can sign in to your Health and Dental SecureServe Log In. If you wish to speak to someone, our customer service representatives will be happy to help you.